{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T08:09:30Z","timestamp":1779178170525,"version":"3.51.4"},"reference-count":23,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Contralateral recurrence following surgically treated primary spontaneous pneumothorax represents clinical concern yet remains poorly understood. This study aims to expand the current understanding by evaluating a large, multicenter cohort over a 10-year period and to determine the true incidence of contralateral recurrence assessing the potential role of clinical factors in risk stratification. Methods: A total of 479 patients surgically treated for PSP (2012\u20132024) across three Italian high-volume centers were retrospectively reviewed. Secondary pneumothorax, patients &lt;18 years old, lung emphysema or intraparenchymal large bullae, and the thoracotomy approach were excluded. The association between categorical variables and contralateral recurrence was assessed using the chi-square (\u03c72) test, while the association with continuous variables was evaluated using the t-test. Time to recurrence was analyzed using Kaplan\u2013Meier survival curves. Variables with a p-value &lt; 0.05 were considered statistically significant. Results: We identified 59 patients who experienced contralateral recurrence: 45 were males, the mean age was 26.66 \u00b1 12.32 and the mean BMI was 22.00 \u00b1 2.92; only 13 were active smokers. Age (p &lt; 0.001) and smoking history (p = 0.029) were significantly associated with contralateral recurrence in univariate analysis, though these were not confirmed in multivariate analysis. Among the cohort of recurrence, 53 patients only had a recurrence on the contralateral side, with a median time to recurrence of 139 days. The incidence rate ratio (IRR) of recurrence for patients with a mean age of &lt;34 years was 1.23, which translates to a 23% increased risk. No significant impact of age (p = 0.25), sex (p = 0.67), or smoking (p = 0.59) on the time to recurrence on the other side was observed through Kaplan\u2013Meier analysis. The peak incidence for the first episode of PNX surgically treated and contralateral recurrence was observed in October, November and January. Conclusions: This study highlights a 12% contralateral recurrence rate after PSP surgery. Younger age is associated with earlier contralateral recurrence. Seasonality may influence recurrence patterns. Further studies should explore underlying mechanisms and preventive strategies.<\/jats:p>","DOI":"10.3390\/jpm16050257","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T13:10:42Z","timestamp":1778505042000},"page":"257","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contralateral Recurrence and Temporal Trend After First Side Surgery for Primary Spontaneous Pneumothorax: A Multicenter Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4058-5539","authenticated-orcid":false,"given":"Antonio Giulio","family":"Napolitano","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2937-9678","authenticated-orcid":false,"given":"Dania","family":"Nachira","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5635-6303","authenticated-orcid":false,"given":"Gloria","family":"Santoro","sequence":"additional","affiliation":[{"name":"General Surgery Unit, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1963-8592","authenticated-orcid":false,"given":"Eleonora","family":"Coviello","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University of Perugia Medical School, Ospedale Santa Maria della Misericordia, Piazzale Giorgio Menghini 3, 06129 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5563-0331","authenticated-orcid":false,"given":"Maria Teresa","family":"Congedo","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Sanguigni","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4553-3973","authenticated-orcid":false,"given":"Domenico","family":"Pourmolkara","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University of Perugia Medical School, Ospedale Santa Maria della Misericordia, Piazzale Giorgio Menghini 3, 06129 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7271-8300","authenticated-orcid":false,"given":"Chiara","family":"Scognamiglio","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9659-1014","authenticated-orcid":false,"given":"Leonardo","family":"Petracca Ciavarella","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9396-373X","authenticated-orcid":false,"given":"Adriana","family":"Nocera","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7233-5809","authenticated-orcid":false,"given":"Maria Letizia","family":"Vita","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felice","family":"Mucilli","sequence":"additional","affiliation":[{"name":"Department of General and Thoracic Surgery, \u201cSS. Annunziata\u201d University Hospital, Via Dei Vestini, 1, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacopo","family":"Vannucci","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University of Perugia Medical School, Ospedale Santa Maria della Misericordia, Piazzale Giorgio Menghini 3, 06129 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Meacci","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Puma","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University of Perugia Medical School, Ospedale Santa Maria della Misericordia, Piazzale Giorgio Menghini 3, 06129 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Lococo","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Margaritora","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1800864","DOI":"10.1183\/13993003.00864-2018","article-title":"Recurrence rates in primary spontaneous pneumothorax: A systematic review and meta-analysis","volume":"52","author":"Walker","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1093\/icvts\/ivv022","article-title":"Risk factors for postoperative recurrence of spontaneous pneumothorax treated by video-assisted thoracoscopic surgery","volume":"20","author":"Imperatori","year":"2015","journal-title":"Interact. Cardiovasc. Thorac. 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Care Med."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/5\/257\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T07:56:04Z","timestamp":1779177364000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/5\/257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,9]]},"references-count":23,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["jpm16050257"],"URL":"https:\/\/doi.org\/10.3390\/jpm16050257","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,9]]}}}